Cardiometabolic Response to Saroglitazar in a Young Indian Man With Obesity, Prediabetes, Insulin Resistance, and High-Normal Albuminuria: A Case Report

A 22-year-old Indian man presented to the outpatient clinic for a routine health check and had a body mass index (BMI) of 27.6 kg/m², which falls within the obesity range according to the Consensus Statement for Asian Indians, although it would be classified as overweight by Western cut-offs. Laboratory evaluation revealed prediabetes according to American Diabetes Association (ADA) criteria, along with elevated liver enzymes, insulin resistance, and high-normal urine albumin-to-creatinine ratio (UACR). Saroglitazar 4 mg once daily was initiated with structured lifestyle counselling. After three months of treatment, the patient demonstrated improvements in glycemic control, insulin resistance, liver enzyme levels, and urinary albumin excretion. A concurrent weight reduction of 1.3 kg was observed following initiation of saroglitazar, despite no reported changes in lifestyle modification or dietary advice compared with the two preceding visits, during which no weight change had occurred; however, this modest change may fall within ordinary biological variation, and its relative contribution from lifestyle versus pharmacological factors cannot be established from this single, uncontrolled observation. The overall direction of these changes suggests potential beneficial effects of early pharmacological intervention across metabolic, hepatic, and renal parameters. However, adequately powered controlled trials are needed before such early intervention strategies can be recommended for routine clinical use.